Israel: controlan con éxito tumores malignos con un tratamiento intestinal

un-equipo-de-israel-controlo-con-exito-tumores-malignos-con-un-tratamiento-intestinal
un-equipo-de-israel-controlo-con-exito-tumores-malignos-con-un-tratamiento-intestinal

Por primera vez en el mundo, un equipo de Israel controló con éxito tumores malignos con un tratamiento intestinal. Nueva esperanza contra el mal.

Modificar el microbioma intestinal puede reprogramar el sistema inmunológico para atacar tumores malignos. Así lo informó un ensayo clínico único realizado en el Centro Médico Sheba de Israel.

Los resultados fueron publicados en la revista científica Science. El estudio fue llevado a cabo por un equipo de investigación dirigido por el oncólogo gastrointestinal principal Ben Boursi, el oncólogo senior Gal Markel y el estudiante Erez Baruch.

“Por primera vez en la historia, peleamos con éxito contra los tumores cancerosos cambiando el microbioma intestinal. En la actualidad, la inmunoterapia funciona solo para el 40 al 50 por ciento de los pacientes pero hoy podemos anticipar que con la ayuda de este tratamiento revolucionario, veremos a tantos pacientes como sea posible transformándose de no respondedores a respondedores”, afirmó el doctor Boursi.

Los investigadores realizaron un trasplante de microbiota fecal (FMT) en una decena de pacientes terminales con melanoma metastásico que no habían respondido a la inmunoterapia y habían agotado todas las demás opciones de tratamiento existentes.

“En la primera fase, erradicamos el microbioma existente del paciente después de lo cual trasplantamos microbiota intestinal de sobrevivientes de cáncer que habían tenido melanoma pero que habían respondido bien a la inmunoterapia y que habían estado libres de cáncer durante al menos un año”, explicó explicado.

Resultados relevantes

Medio mes después de haber introducido el microbioma del donante mediante una colonoscopia -y los pacientes hubieran absorbido por completo la microbiota del donante-, se reanudó la inmunoterapia.

Durante un trimestre, los pacientes recibieron píldoras inodoras e insípidas que contenían las mismas bacterias.

En dos de los participantes del estudio, los tumores se redujeron de forma significativa. El tumor de un paciente desapareció y, dos años después, no había vuelto a crecer.

Leer más: Israel descifra el «talón de Aquiles» del cáncer

Lo más significativo es que Boursi y su equipo vieron evidencia de una mayor respuesta inmune a nivel celular, así como en los perfiles de expresión genética de los tres pacientes que respondieron bien. “Ver una respuesta del 30 por ciento es algo realmente extraordinario”, le contó Boursi a ISRAEL21c al considerar la condición terminal de los participantes y sus tratamientos fallidos anteriores.

Boursi afirmó que cree que algunos de los pacientes trasplantados no respondieron a la inmunoterapia debido a cambios genéticos en sus tumores. Eso significa que el microbioma no es el único factor que puede afectar la respuesta al tratamiento.

“Si bien enfatizamos en  el beneficio clínico del tratamiento, debemos recordar que es la cereza del pastel. Nuestro principal objetivo era ver si el tratamiento es seguro y factible”, describió el especialista.

Ahora que se demostró que el trasplante de microbioma es “sencillo, seguro y relativamente económico”, Boursi y el equipo del Sheba lo prueban en otros pacientes con melanoma y cáncer de pulmón, una de las causas más comunes de la muerte por cáncer.

Sin efectos secundarios

Al margen de si esto afectó o no el éxito de la inmunoterapia, hubo otro beneficio inesperado; si bien muchos de los participantes del ensayo habían sufrido efectos secundarios graves durante su fallida ronda anterior de inmunoterapia, el tratamiento de trasplante de microbiota no mostró nada de eso.

“Por sí solo, eso es un logro tremendo”, dijo Boursi. Ahora, el equipo explora si el tratamiento de trasplante podría usarse de forma específica para ayudar a aliviar los efectos secundarios de la inmunoterapia.

Los científicos dijeron que su trabajo de laboratorio continuo puede ayudarlos a identificar a los pacientes con cáncer que se beneficiarán más de la terapia. Como así también a identificar al donante más apropiado para cada paciente. También esperan definir la vía biológica subyacente al cambio en la capacidad de respuesta inmune.

¿Qué tiene el microbioma intestinal que puede marcar la diferencia en el éxito de la inmunoterapia? “Sabemos que el microbioma intestinal tiene muchas funciones en la salud humana, y una es el desarrollo del sistema inmunológico. Un ejemplo: en ratones libres de gérmenes, el sistema inmunológico no se desarrolla de forma correcta”.

Otros autores del estudio pertenecen a la Universidad de Tel Aviv, el Centro Médico Shamir, el Centro Médico Hadassah, la Universidad Bar-Ilan y el Hospital Universitario Assuta de Ashdod.

Israel21c

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